Naturally, the safety of children is very important to us. OnePlace.com will not knowingly accept personal information from children under the age of 13 without obtaining parental consent. Such consent may be obtained by a parent filling out and signing the form below and returning the form via United States mail or facsimile.

If a parent wishes to refuse to permit collection or use of their child's information by OnePlace.com, that parent can send an email to feedback@oneplace.com to request deletion of their child's account.

Please FAX or email the form below to:
Bill Long, Director of Streaming Media Services FAX: 804-205-9651
E-mail: bill@salemweb.net

I, _________________, am the parent or legal guardian of
________________ ("Child"), a child under the age of 13.
I understand that I am authorizing the Child to have
full access to OnePlace.com and the products and services
it provides ("Service"). I understand that the Child
will be sent an email newsletter and have access to various
commercial products including advertising links to
sites located outside and not under the control of OnePlace.com.

I have read the OnePlace.com Privacy Policy and
Terms of Use and hereby consent and agree to the terms
and conditions contained therein. I also understand that
the Service may provide links to other Web sites and Services
not under the direct control of OnePlace.com, and that it may
not always be clear to me or my Child when we leave the
OnePlace.com Web site to receive content from another Web
site or provider. As a result I agree that OnePlace.com will
not be liable for any damages incurred by the Child, either
directly or indirectly, from the use of the Service.

I recognize that I can remove the personal information
of the Child from any and all customer lists maintained
by OnePlace.com.

Name [print]: ______________________

Phone number: _________________________

Address:
_________________________
_________________________
_________________________

Current e-mail address: _________________________
Social Security number: ________________________
Drivers License number: _____________________ State: ________
* We request the above information only for the purpose of
confirming identity and preventing forgery of this form.

Signature: _______________________________

Date: _________